Republican health care bill pushes past House- MAY 5, 2017

On May 4, the U.S. House of Representatives voted to pass a bill that would repeal the Affordable Care Act in favor of the American Health Care Act. The latest version of the Republican-led legislation does away with tax penalties for the uninsured, cuts taxes for high-income citizens by $300 billion over the next 10 years, and rolls back Medicaid expansion.

The House bill also allows states to opt out of the Obamacare requirement that insurers charge people the same for coverage regardless of pre-existing conditions. NBC News reported: “If states opt out, insurers can charge sick people far more for plans if their coverage has lapsed and coverage also might not include treatments for their condition. States that go this route would have to set up some kind of mechanism, like a high-risk pool, to try and help otherwise uninsurable consumers get coverage.”

The House passed the bill before the Congressional Budget Office could assess the economic impact of the legislation. The CBO report on the previous version of the bill to repeal and replace Obamacare said that it had the potential to eradicate medical coverage for up to 24 million Americans.

Former CBO director Douglas Elmendorf said it was wrong for the House to vote on the bill before the CBO report. Elmendorf said in an interview with Marketplace.org: “CBO will produce an estimate of this bill, then they will produce estimates of whatever bill the Senate takes up and whatever a compromise bill might be reached between the House and Senate. But it is a terrible mistake for the House to proceed without a CBO estimate at this point. That just violates the very sensible norms of knowing what you’re voting on before you vote.”

The House bill passed with a vote count of 217 for to 213 against. 216 votes were needed to win the count. No Democrats voted in support of the bill.

House Speaker Paul Ryan (R-WI) said the bill’s passage was just one important step in repealing Obamacare. “The issues are too important. The stakes are just too high. The problems facing American families are real,” Ryan said. “The problems facing American families as a result of Obamacare are just too dire and too urgent. The truth is, this law has failed and it is collapsing. Premiums are skyrocketing and choices are disappearing.”

The Republicans’ repeal and replace efforts, however, have been criticized for potentially allowing millions to lose health care coverage.

Seattle Mayor Ed Murray released a public statement Thursday morning, condemning the AHCA as “a devastating blow to millions of Americans who need access to health care.”

Update 5/11/17 at 4:04 p.m.:

The following is a statement from International Community Health Services (ICHS) CEO Teresita Batayola:

“The latest news raised alarms about the loss of guaranteed coverage for those with existing illnesses or pre-existing conditions. This is tragic for those who face astronomical bills to get well or maintain their health. What we should not forget is that this bill still contains all the damaging effects of the originally proposed American Health Care Act (ACHA).

“The U.S. House of Representatives’ passage of the ACHA rolls back Medicaid and subsidized health plans for the working poor. 24,000,000 nationally stand to lose coverage, with up to 100,000 Washingtonians losing their private health care insurance and another 600,000 losing their coverage under Apple Health, our state Medicaid program. This means 6,000 ICHS patients are jeopardized because they got covered when Medicaid was expanded to include families and individuals who earn low wages—a family of four making less than $40,000 a year or an individual who earns less than $17,000 a year. An additional 2,200 ICHS patients will no longer be able to afford insurance coverage because they will lose medical subsidies and tax credits.

“More harm will come when states opt out of requiring plans to cover some or all essential health benefits like primary care, maternity and newborn care, prescription drugs, mental health and other services. The many changes also includes a cap on the federal share of Medicaid coverage.

“We are fortunate to be in a state that believes in taking care of its low income, uninsured and under-insured residents. But the state will potentially lose $1.4 billion a year if the U.S. Senate adopts what the U.S. House passed. Losing this funding means the state will have to make healthcare cuts for its most vulnerable populations.

“ICHS believes in healthcare as a human right. We have served our communities’ health care needs for 44 years. We will continue to advocate and champion our communities’ access to high quality, affordable health care. Our U.S. Senators Patty Murray and Maria Cantwell support community health centers and Medicaid but we need our entire community to reach out to their friends and families in other states to make sure that the US Senate does not pass the AHCA.”

Update 5/11/17 at 4:13 p.m.:

The following is a statement from Asian Counseling and Referral Service (ACRS) executive director Diane Narasaki:

“Asian Americans and Pacific Islanders benefited greatly from the passage of the Affordable Care Act (ACA, popularly known as Obamacare). Some of our ethnic groups were among the lowest insured of any community. Our rate of uninsurance was approximately halved with Obamacare. This was largely due to the Medicaid expansion which covered more people and government subsidies which made healthcare coverage more affordable.

“Various features of Obamacare were especially important for AAPIs, as well as the rest of the country. AAPIs experience health disparities, such as disproportionate rates of diabetes, hepatitis B, certain types of cancer, cardiovascular disease, and higher rates of mental health issues for environmental rather than biological reasons, for instance. Under Obamacare, insurance companies are required to offer coverage for pre-existing conditions, and for essential services, including maternity services, mental health and drug addiction treatment, to name a few. Under Obamacare, there is no lifetime cap on coverage. The House Republicans’ American Healthcare Act (AHCA), if implemented as passed without changes from the Senate, would remove these requirements, which could make premiums for coverage for people with pre-existing conditions much more expensive, raising the cost by thousands of dollars, and coverage less accessible for people, if they were not outright denied coverage at all for pre-existing conditions. The funds the AHCA includes for state high risk pools to address the needs of people with pre-existing conditions are not nearly adequate; state high risk pools have not been known to be effective for people with pre-existing conditions and other health needs in the past. Various AAPI ethnic groups experience disproportionate rates of poverty, as well as health disparities, and would be disproportionately affected by these changes.

“Medicaid is our nation’s healthcare safety net not only for low-income people, but also people with physical and mental disabilities and middle class seniors who cannot afford nursing home care costs for long when they require that level of care, to name a few common examples. The House AHCA cuts Medicaid by over $800 billion over a period of years, would impose limits on Medicaid and could block grant Medicaid funds in smaller amounts to the states, thereby shifting the costs to the states. The states would not be able to cover the $800 billion lost at the federal level, and could be forced to ration care by cutting or eliminating some health services for people who cannot afford the steeply rising costs of care. This would have a catastrophic effect for the healthcare of millions, including potentially 2 million AAPIs. Since many AAPIs have health coverage through Medicaid, AAPIs will be disproportionately affected. The House AHCA cuts subsidies that make healthcare more affordable in the private insurance market, and will affect AAPIs who rely on these subsidies for coverage.

“The House AHCA also transfers around $800 billion in tax breaks to wealthy individuals and entities whose taxes currently help support Obamacare’s subsidized care for people with lower incomes. Commentators have remarked that this aspect of the AHCA is “Robin Hood in reverse,” taking survival benefits from those who cannot afford healthcare and redistributing the income saved to the wealthy and corporate entities.

“There are many things we will need to keep an eye on, now that the bill has gone to the Senate. Among the most important are whether the Senate will stop the House bill’s elimination of Obamacare’s Medicaid expansion and the bill’s cost shifting and reductions to the states through block granting or other mechanisms, whether the Senate will restore Obamacare’s subsidies to make coverage more affordable, and whether the Senate will restore Obamacare’s requirement for insurance plans to cover pre-existing conditions and essential health services while eliminating the lifetime limit to coverage.

“Everyone who cares about health care for all, rather than only those who can afford the high cost of health care, should contact their U.S. Senators now and urge them to vote no on any bill that reduces or eliminates Medicaid funding to states or tries to shift costs to the states through block grants and other mechanisms, and any bill that causes millions to lose their healthcare coverage.”

The Asian and Pacific Islander American Health Forum (APIAHF) said that the AHCA threatens to eliminate medical coverage for up to 2 million members of the API community across the country and that 17% of the country’s Asian American population will completely lose medical coverage, putting millions at risk of sickness and death. Kathy Ko Chin, president and CEO of APIAHF said in a statement: “The ACA has been a literal lifeline for Americans around the country and Congress’ plan to repeal the law threatens to undo much of that. Repealing the ACA stands in stark contrast to the proven success of the law- historical gains in coverage and access to care.”

Congresswoman Pramila Jayapal (D-WA) called the House bill “immoral” and “unconscionable.” “This bill will raise premiums and deductibles for millions of Americans across our country to transfer almost $1 trillion dollars in tax cuts to millionaires, billionaires and corporations,” Jayapal said in a statement. “It is difficult to imagine what world my Republican colleagues are in that they could vote yes on such a bill. I cannot imagine how they will go home and face grandmothers who will be kicked out of nursing homes or kids with asthma who will no longer be able to afford inhalers. I cannot imagine what they will say to women in their districts who will pay more for simply being women, or be barred from care if they have a C-section—which is now considered a pre-existing condition.”

U.S. Senator Bernie Sanders said the Senate needs to stay focused on passing health care legislation that guarantees health care coverage for all Americans without spending as much as we do today.

“If the bill passed today in the House became law, thousands of Americans would die, because they would no longer have access to health care,” Sanders told CNN.